• Title/Summary/Keyword: Randomized Clinical Trials

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A Systemic Review of Clinical Trials Using Medication for Acute Bronchitis: A Pre-study on the Development of Traditional Korean Medicine Clinical Practice Guideline (급성기관지염의 약물중재 임상시험에 대한 체계적 문헌 고찰: 임상시험 가이드라인 개발을 위한 예비연구)

  • Lyu, YeeRan;Park, So jung;Lee, Eun Jung;Jeon, Ju Hyun;Jung, In Chul;Park, Yang Chun
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.93-111
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    • 2017
  • Objectives: The aim of this study is to make evidence-based data for developing a traditional Korean medicine clinical practice guideline for acute bronchitis. Methods: We searched 3 international databases(PubMed, EMBASE, CENTRAL) and 7 domestic databases (KoreaMed, Kmbase, NDSL, KISS, KISTI, OASIS, KoreaTK) to identify randomized controlled trials (RCTs) of acute bronchitis using medicine in recent 10 years. The chosen trials were analyzed by their study design, age range, intervention group, control group, primary and second outcome measure, inclusion and exclusion of participants and adverse events. Results: 15 RCTs are finally included in this study and most of their medications are herbal medicine. For diagnosis and outcome measure of acute bronchitis, Bronchitis Severity Score(BSS) was mostly used. Other measurements eligible are coughing fits, quality of life scale, sputum viscosity, change of individual symptoms and patient's satisfaction. Test duration was for average 7days and safety assessment was held by recording adverse events. Except for anti-inflammatory and antibiotic trials, all medications are found to be effective and well-tolerated. General risk of bias of chosen trials is evaluated low. Conclusions: A well designed clinical trials for traditional Korean medicine of acute bronchitis is needed and this study is expected to make it available.

Placebo Control and Placebo Effect in Acupuncture Medicine (침구의학에서 플라시보 대조군과 플라시보 효과)

  • Chae, Younbyoung;Enck, Paul
    • Korean Journal of Acupuncture
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    • v.35 no.2
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    • pp.47-55
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    • 2018
  • Objectives: Clinical improvements can be observed following placebo administrations in clinical trials. Randomized controlled trials have been conducted to disentangle the specific effects of therapeutic interventions over the past decade. In acupuncture trials, non-penetrating placebo needles offer the opportunity to determine the specific effects of needling. Methods: The present review provides an overview of the concept of the placebo effect and the characteristics of the placebo needles. Results: Placebo control can contribute to minimize for bias and the contextual and psychological components of therapeutic interventions. Placebo control should meet two criteria: blinding efficacy (indistinguishable from active treatment) and physiological inertness. In the case of acupuncture, however, it is difficult to meet both criteria simultaneously. The dilemma of placebo needles suggests that placebo needles do not constitute proper control in acupuncture research. Considering the characteristics of placebo needles, patients are more likely to perceive placebo needles as active treatment in acupuncture trials compared to placebo pills in pharmaceutical trials. Placebo response might be observed more frequently to placebo needles than to placebo pills. When acupuncture treatments are utilized in clinical use, placebo effects can be enhanced by exploiting patients' expectations in the contextual or environmental cues that surround medical intervention. Conclusions: We have to consider these unique characteristics of placebo needles in order to avoid drawing premature conclusions that acupuncture itself is just a placebo.

The Analysis of Registration Status of Herbal Medicine and Medication Interventional Clinical Trials for Simple Obesity in Children and Adolescents -Focused on WHO ICTRP- (소아청소년 단순 비만에 대한 한약 및 약물 중재 임상시험 등록 현황 분석 - WHO ICTRP를 중심으로 -)

  • Jeong Yoon Kyoung;Choi Seo Yeon;Bang Miran;Lee Boram;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.1
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    • pp.55-77
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    • 2024
  • Objectives This study aimed to analyze the registration status and characteristics of clinical trials on herbal medicine (HM) and medication interventions for simple obesity in children and adolescents. Methods All interventional clinical trials registered in the International Clinical Trials Registry Platform of the World Health Organization until December 12, 2024, were collected. The study design, interventions, inclusion and exclusion criteria, and outcome measures were extracted. Results A total of 24 clinical trials (23 medications and 1 HM) were analyzed. The most common study designs were single-center, randomized controlled, parallel, and phase 2. Placebo controls were used in 87.5% of the studies, blinding was used in 79.1%, and quadruple blinding was the most common. Informed consent was obtained from 70.8% of the participants. Among the oral medications (66.6%), metformin was the most common (25%). Among the non-oral medications (29.1%), exenatide (Bydureon) was the most common intervention (42.8%). Body mass index was the most commonly reported primary outcome measure (79.1%), with most assessments performed at 6 months. Conclusions Based on the characteristics of the medication interventional clinical trial design analyzed in this study, additional high-quality multicenter traditional Korean medicine trials need to be designed in the future.

Current Status of N-of-1 Trials for Herbal Medicine -Literature Review (한약에 대한 N-of-1 임상시험의 현황 - 문헌 고찰)

  • Jeung, Chang-woon;Jeon, Sun-woo;Jo, Hee-Geun
    • The Journal of Korean Medicine
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    • v.41 no.1
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    • pp.107-116
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    • 2020
  • Objectives: To overcome the limitations of randomized controlled trials, many other trials design is tested. The n-of-1 trial is a promising research method in the field of Korean medicine because of this methodology can examine the optimal treatment for each patient strictly. Therefore, we reviewed the status of N-of-1 studies on herbal medicine. Methods: A systematic literature review was conducted based on the pubmed database. The search term were 'N-of-1 Trial', 'Chinese Medicine', 'Herbal Medicine', 'Kampo'. There was no restriction in year. Results: Four clinical trials have been identified to demonstrate the effectiveness of herbal medicines for Kidney-yin-deficiency syndrome, bronchiectasis and gastric cancer. These studies suggest that the N-of-1 design is a study that encourages patient involvement, demonstrates the effectiveness of herbal medicines and helps reduce unnecessary medication. Conclusion: The N-of-1 clinical trial may be a rigorous methodology suitable for the clinical setting and may help the development of evidence-based Korean medicine. Attention is also needed in this research method in Korea.

A Review on Randomized Controlled Trials of Herbal Medicine Treatment for Pregnancy-induced Hypertension (임신성 고혈압의 한약 치료에 대한 무작위 대조군 연구의 문헌고찰)

  • Hwang, Su-In;Yoon, Young-Jin;Park, Jang-Kyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.3
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    • pp.119-135
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    • 2020
  • Objectives: The purpose of this study is to confirm the effectiveness and safety of herbal medicine treatment for treating pregnancy-induced hypertension. Methods: We searched for randomized controlled trials of pregnancy-induced hypertension treated with herbal medicine, through nine databases. Interventions and results of the selected clinical studies were analyzed. Results: Eleven randomized controlled trials were finally included according to the inclusion and exclusion criteria. Treatment group was treated with herbal medicine alone in two studies, and with herbal medicine and western medicine in nine studies. Control group was treated with western medicine. Taxilli Ramulus (桑寄生) (54.5%) was the most frequently used herb in herbal medicine treatment. In all of eleven studies, treatment group was more effective for pregnancy-induced hypertension than the control group. Conclusions: This study suggested that herbal medicine treatment alone or combined with western medicine treatment could be helpful in improving the therapeutic effect on pregnancy-induced hypertension and reducing side effects as well. However, in order to obtain stronger evidence of herbal medicine treatment for pregnancy-induced hypertension, more high-quality and well-designed randomized controlled trials should be conducted.

A Systematic Review of Acupuncture-Moxibustion Treatments for Nonspecific Chronic Neck Pain (비특이적 목 통증에 사용된 침구치료에 대한 체계적 문헌고찰)

  • Yang, Chang-Sop;Kim, Ick-Tae;Kim, Young-Eun;Kim, Bo-Young;Seo, Bok-Nam;Park, Ji-Eun
    • Korean Journal of Acupuncture
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    • v.34 no.4
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    • pp.209-230
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    • 2017
  • Objectives : The aim of this study was to describe the details and to assess the clinical evidence of acupuncture and moxibustion for non-specific chronic neck pain. Methods : We searched seven databases including Korean, English, and Chinese databases through July 2016. Studies using acupuncture, moxibustion, pharmacopuncture, electroacupuncture, auricular-acupuncture, acupressure for non-specific chronic neck pain were included. Only controlled clinical trials or randomized clinical trials were assessed. Study design, number of subject, inclusion criteria, intervention, and results were extracted. In addition, details of intervention including needle type, retention time, acupoints were analyzed. Results : Total 64 studies(39 acupuncture, 9 laser, 6 pharmaco-acupuncture, 3 electro-acupuncture, 3 auricular-acupuncture, 3 moxibustion, 1 acupressure) were included. Among 39 acupuncture studies, 35 used acupuncture as sole intervention. Sham treatment was the most common intervention for control group, followed by no intervention. Various outcome including pain, disability, quality of life, range of motion was used as outcome measurement. The effect of acupuncture and moxibustion was different depending on the type of control and outcome measurement. The most commonly used method in acupuncture for neck pain was GB21, SI3, GB20, LI4, BL11 acupoints, 10~30 mm insertion depth, 20~30 retention time, and 1~2 times per week. Conclusions : Analyzing the details of acupuncture and moxibustion treatment could be helpful for researches and clinics. Further studies should consider the characteristics of study design, intervention, and outcome to assess the effect of TKM.

Analysis of the current status of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance (건강보험 급여 한약제제 56종 처방의 계량적 문헌 근거 현황 분석)

  • Chul Kim;Hyeun-kyoo Shin
    • The Journal of Korean Medicine
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    • v.44 no.3
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    • pp.189-200
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    • 2023
  • Objectives: The purpose of this study is to analyze the current state of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance that have been studied in Korea for the past 30 years, to evaluate the reliability of the evidence, and to find out the research direction of herbal medicine prescription in the future. Methods: 56 kinds of herbal medicine prescriptions were searched in domestic literature search databases OASIS, DBpia, and overseas PubMed, classified into chemistry, toxicity, cells, animals, clinical cases, and clinical trial studies, and built into an EBM pyramid structure. Results: When classified according to research contents, there were 61 cases (7.5%) of physicochemical analysis to identify constituent substances, 80 cases (9.8%) of toxicity evaluation, and 672 cases (82.7%) of efficacy evaluation. The efficacy evidence was classified according to the evidence-based medical pyramid structure: 196 cell trials (29.1%), 372 animal trials (55.4%), 89 case and case reporting series (13.3%), 7 comparative case studies (1.1%), and 8 randomized control clinical trials (1.2%). In the pyramid composition, the basis for the validity of 56 kinds of herbal medicines prescribed was 568 cases (84.5%) in cell and animal units, which could not be said to be highly reliable. There was no relationship between the ranking of quantitative literature evidence for herbal medicine prescriptions and the ranking of salary administration. Conclusions: In an era that continues to require scientific evidence for herbal medicine, traditional herbal medicine should secure the basis for safety validity even for the 10th most frequent prescription among 56 herbal medicine prescriptions for consumers. In particular, traditional herbal medicine should increase the quantitative and qualitative level of case reports on related herbal medicine prescriptions, focusing on each clinical society, and move toward comparative case studies and randomized clinical trial so that traditional herbal medicine is positioned as Evidence-based medicine.

Electroacupuncture for Treatment of Primary Dysmenorrhea: Systematic Review of Randomized Controlled Trials (원발성 월경통의 전침 치료 연구에 관한 체계적 문헌 고찰)

  • Park, Nam-Chun;Kang, Na-Hoon;Yoo, Eun-Sil;Lee, Jin-Wook;Yoon, Jun-Geol;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bok;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.2
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    • pp.81-92
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    • 2017
  • Objectives: This review aims to report the efficacy and safety of electroacupuncture in the treatment of primary dysmenorrhea. Methods: We searched for randomized controlled studies (RCTs) using electroacupuncture on primary dysmenorrhea up to Dec 2016. The following databases were searched : OASIS, PubMED, EMBASE, CENTRAL. The results of the studies were analyzed and the risk of bias was assessed. Results: Five studies were included in this review. In most studies, the effect of electroacupuncture at Sameumgyo (SP6) was better than that of electroacupuncture at Hyeonjong (GB39), nonacupoint and no intervention about Visual analog scale (VAS), Verbal rating scale (VRS) and Retrospective symptom scale (RSS). But there were no significant effects on Resistance Index (RI) and S/D ratio (the ratio between peak systolic to end-diastolic flow velocity in uterine arteries). Serous adverse events were not reported. Conclusions: This review shows that electroacupuncture is effective on primary dysmenorrhea with no serious adverse events.

An Intensive Review On Clinical Thesis about Hwangryunhaedok-tang Pharmacopuncture Treatment: Focused on Case Reports and Controlled Studies in Korean Academic Journals (황련해독탕약침 치료에 대한 임상 논문 고찰: 국내 학술지의 증례보고와 대조군 연구 중심으로)

  • Lee, Soo-Hwan;Kim, Soon-Joong
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.2
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    • pp.171-188
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    • 2019
  • Objectives The purpose of this thesis is to compare and analyze outcomes of case studies and controlled studies about Hwangryunhaedok-tang (HHT) pharmacopuncture in clinical studies. Based on these studies reporting clinical effects by using HHT pharmacopuncture, we object to deduct the comparative review in applying clinical disorders limitedly. And conclusionally, by using this comparative review, we aim to make the fine evidence in treating clinical specific diseases. Methods We searched 106 studies about HHT pharmacopuncture from 6 Korean web databases by using in Korean word 'Hwangryunhaedok-tang pharmacopuncture'. This search had been progressed throughout 1 month (January, 2019). There was 106 thesis and we excluded studies that are not related to HHT pharmacopuncture, experimental research, not the case report or randomized controlled trials, non-randomized controlled trials, not using HHT pharmacopuncture, not using only one pharmacopuncture, and not using HHT pharmacopuncture for major treating method. As a result, 39 thesis are selected as a population. Results We analyzed 34 case reports and 5 controlled studies. As the final outcome, HHT pharmacopuncture was used in musculoskeletal diseases, dermatopathy, and 32 specific diseases. Conclusions After analyzing 39 studies, effective symptom changes clinically and statistically by using HHT pharmacopuncture herbal acupuncture were identified. However, these thesis designs were reported deficiently in many parts such as not excluding other confounding variables. After modifying defects of thesis design and conduct study, it can play a role as the evidence using HHT pharmacopuncture more precisely.

A Clinical Research Analysis of the Korean Medicine for Peroneal Nerve Palsy (비골신경마비에 대한 국내 한의치료 임상연구 동향 분석)

  • Hong, Su Min;Lee, Eun Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.61-74
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    • 2019
  • Objectives This study aimed to review clinical studies about Korean medicine used in peroneal nerve palsy. Methods In 11 online databases (Earticle, Research Information Sharing Service, Oriental Medicine Advanced Searching Integrated System, KMbase, Korean Traditional Knowledge Portal, National Digital Science Library, MEDLINE/Pubmed, Ebscohost, Cochrane CENTRAL, EMBASE, China National Knowledge Infrastructure), we searched clinical studies about Korean medicine. Among the studies that we've searched, we excluded the studies that are not related to Korean medicine, case reports, randomized controlled trials and retrospective studies. As a result, 16 case studies and 1 randomized controlled trial are included. Results Total number of patients was 123. In these studies, acupuncture (100%), herbal medicine (58.8%), pharmacopuncture (58.8%), Korean physical therapy (58.8%), moxibustion (41.1%), cupping (41.1%) etc. were used. In acupuncture, GB34 and ST36 were most frequently used. Most of the herbal medicines used in these studies were different. Range of movement were most frequently used in outcome measure. Conclusions In this study, we reviewed studies about Korean medicine used in peroneal nerve palsy. It was difficult to clearly determine which intervention has improved the symptom. In the future, Further clinical studies will be needed to retain the evidence for the treatment of peroneal nerve palsy. And also more randomized controlled clinical trials to prove the efficacy of Korean medicine will be needed.